Exam 2 Flashcards

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1
Q

What two systems are activated during fight or flight response?

A

1) autonomic nervous system
2) adrenal-cortical system

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2
Q

what initiates the autonomic nervous system in the fight or flight response?

A

the hypothalamus

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3
Q

what sends a signal in the adrenal-cortical system during the fight or flight response

A

the pituitary gland

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4
Q

describe panic disorder

A

recurrent, unexpected panic attacks

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5
Q

what course does panic disorder usually take?

A

chronic

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6
Q

What is anxiety sensitivity?

A

unfounded belief that bodily symptoms have harmful consequences

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7
Q

What is interoceptive awareness?

A

heightened awareness of bodily cues that may indicate an oncoming panic attack

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8
Q

What is interoceptive conditioning?

A

how certain bodily cues become a conditioned stimulus and illicit a panic attack as a response

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9
Q

what kinds of medications are used to treat panic disorder?

A

medications that affect serotonin and norepinephrine

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10
Q

what is the issue with the biological treatment of panic disorder?

A

a relapse after ending medication

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11
Q

What are the goals of CBT for panic disorder?

A
  • relaxation and breathing exercises
  • identify and challeng catastrophizing cognitions
  • sytematic desensitization
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12
Q

describe GAD

A
  • excessive anxiety about ordinary, everyday situations
  • anxiety is intrusive, causes distress or functional impairment
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13
Q

what are the comorbidities of GAD?

A

80% will have a comorbidity. often MDD

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14
Q

what is the course of GAD?

A

chronic

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15
Q

Describe the emotional components of GAD

A
  • more intense negative emotion
  • highly reactive to negative emotion
  • emotions are not controllable or manageable
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16
Q

Describe the cogitive factors of GAD

A
  • maladaptive assumptions
  • hypervigilant to posible threats
  • overreactions
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17
Q

What do the maladaptive assumptions from GAD often reveal?

A
  • fear of losing control
  • being unable to tolerate uncertainty
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18
Q

What are the goals of CBT for GAD?

A
  • confronting most worrisome issues
  • challenging catastrophizing thoughts
  • developing coping strategies
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19
Q

what are the drugs used to treat GAD?

A
  • benzos
  • tricyclic antidepressants
  • SSRI
  • SNRI
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20
Q

are biological or cognitive treatments more effective for GAD?

A

they have equal efficacy

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21
Q

What is the main factor that differentiates social anxiety from a general fear?

A

avoiding social situations

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22
Q

what is the course of social anxiety?

A

chronic

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23
Q

What are the comorbidities with social anxiety?

A
  • mood disorders
  • other anxiety disorders
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24
Q

Describe the genetic factors of social anxiety

A

genetic factors do not specifically lead to social anxiety but do lead to a general predisposition to anxiety disorders

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25
Q

Describe the cognitive theory on social anxiety

A
  • excessively high standards for own social perfpormance
  • focus on negative aspects of social interaction
  • evaluate own behaviors harshly
  • note potentially threatening social cues and misinterpret them in self defreating ways
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26
Q

what medications are used to treat social anxiety?

A
  • SSRI
  • SNRI
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27
Q

What are the goals of CBT for social anxiety?

A
  • exposing clients to social situations
  • group therapy to see they are not the only one and to prictice social skills
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28
Q

how is mindfulness used to treat social anxiety?

A

used to accept and observe anxiety

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29
Q

Describe specific phobias

A
  • unreasonable or irrational fears of specific objects/situations
  • fear is disproportionate to actual danger
  • will avoid phobia at all costs
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30
Q

what are the five catagories of specific phobias?

A

1) animal type
2) natual environment type
3) situational type
4) blood-injection type
5) other

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31
Q

what is special about blood-injection type phobias?

A
  • heart rate drops and person faints
  • usually more hereditary
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32
Q

Describe agoraphobia

A
  • fear places where they can’t escape or get help
  • fear they will embarrass themselves if others notice symptoms or escape attempt
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33
Q

What is the most common comorbidity with agoraphobia?

A

50% of people have a history of panic attacks

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34
Q

What is the behavioral theory of specific phobias?

A
  • classical conditioning can create the phobia
  • negative reinforcement (operant conditioning) can maintain a phobia
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35
Q

What is the biological theory of specific phobias?

A
  • 1st degree relatives makes you 3 to 4 times more likely to develop phobia
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36
Q

What is the main goal of behavioral treatments of specific phobias?

A

use exposure to extinguish person’s fear

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37
Q

What components of behavior therapy are used to treat specific phobias?

A
  • systematic desensitization
  • modeling
  • flooding
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38
Q

what is the applied tension technique and what is it used for?

A
  • increases blood pressure and heart rate
  • used for treatment of blood-injection type phobias to keep them from fainting
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38
Q

what is used in the biological treatment of specific phobias?

A

benzodiazapines

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39
Q

Describe obsessions and compulsions for OCD

A
  • obsessions: persistent and uncontrollable thoughts, images, ideas, impulses
  • compulsions: ritualistic behaviors or mental acts
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40
Q

what did the DSM 5 change in regards to OCD?

A

before the DSM 5, OCD was classified as an anxiety disorder. It has now been determined not everyone experiences anxiety

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41
Q

what is the course for OCD?

A

chronic

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42
Q

wha is the major comorbidity of OCD?

A

66% of people will have depression

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43
Q

describe hoarding disorder

A
  • uncontrollable urges to keep items with no utility or value
  • feelings of anxiety when someone tries to throw something out
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44
Q

what are the comorbidities of hoarding disorder?

A
  • depression
  • social anxiety
  • GAD
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45
Q

what is the course of hoarding disorder?

A

increases with age

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46
Q

describe trichotillomania

A
  • unconcious, repeatedly pulling out hairs
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47
Q

describe body dysmorphia

A

excessive concern with part of the body they see as defective, but others see as normal

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48
Q

describe excoriation

A

repeated picking of the skin

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49
Q

What is the biological theory of OCD?

A
  • dysfunction of circuit involved in motor, behavior, cognition, and emotion
  • HPA axis
  • dysregulation of serotonin
  • genetic heritability
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50
Q

What are the cognitive theories of OCD?

A
  • chronic depression/anxiety invoke intrusive thoughts
  • tendency toward rigid, moralistic thinking
  • believe they should be in total control over their thoughts
  • compulsions possibly caused by operant conditioning
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51
Q

What kinds of medications are used to treat OCD?

A

serotonin enhancing drugs reduce compulsions

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52
Q

What is the goal of CBT for OCD?

A
  • exposure and response prevention
  • challenge maladaptive cognitions
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53
Q

what is exposure and response prevention?

A

1) exposure to triggering thing
2) prevention from committing compulsion

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54
Q

what are the criteria for a PTSD diagnosis?

A
  • must be the result of a traumatic experience
  • symptoms must be present for at least a month
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55
Q

what does the DSM constitute as experienceing trauma?

A
  • direct experience of trauma
  • learn about trauma that happened to a loved one
  • repeated or extreme exposure to details of trauma
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56
Q

What does the DSM count as a traumatic experience?

A

expopsure to actual or threat of death, serious injury, or sexual violation

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57
Q

what are the symptoms of PTSD?

A
  • repeated experiencing of trauma
  • avoidance of anything related to trauma
  • negative changes in thoughts and mood
  • hypervigilence or chronic arousal
  • depersonalization or derealization
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58
Q

What is different about acute stress disorder?

A

the symptoms only last for a most 4 weeks

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59
Q

What is different about adjustment disorder

A
  • the stressor does not have to be traumatic
  • arises within 3 months of stressor
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60
Q

What are the 4 catagories of traumatic events?

A

1) natural disasters
2) human made disasters
3) traumatic events
4) sexual assaut

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61
Q

What are the environmental/social factors of PTSD?

A
  • severity, duration, procimity to trauma (experienced vs witness, who did it to you, etc)
  • amount of social support
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62
Q

what are the psychological factors of PTSD?

A
  • pre-existing anxiety or depression
  • coping strategies
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63
Q

what are good and bad coping strategies for PTSD?

A

good: meaning making
bad: substance abuse

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64
Q

What are the biological factors of PTSD?

A
  • brain more ractive to emotional stimulus
  • lw resting cortisol
  • exaggerated physiological response to stress
  • extreme/chronic stress during childhood
  • genetic predisposition
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65
Q

What is the goal of CBT and stress management for PTSD?

A
  • systematic desensitization
  • stress inoculation therapy
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66
Q

what is stress inoculation therapy?

A
  • used if a client can’t think about traumatic event
  • focuses on other stress in client’s life
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67
Q

what medications are used to treat PTSD?

A
  • SSRI
  • benzodiazapines
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68
Q

What are the symptoms of separation anxiety disorder?

A
  • extreme anxiety when separated from caregivers
  • may refuse to leave home
  • worried something may happen to caregiver
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69
Q

what are the criteria for separation anxiety disorder?

A
  • excessive fear that is developmentally inapropriate
  • symptoms for at least 4 weeks
  • significantly impairs functioning
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70
Q

what are the 5 types of somatic disorders in the DSM?

A

1) somatic symptom disorder
2) illness anxiety disorder
3) functional neurologcal symptom disorder
4) factitious disorder
5) psychological factors affecting other medical conditions

71
Q

What are the criteria of somatic symptom disorder?

A
  • one or more distressing physical symptoms
    AT LEAST ONE OF THE FOLLOWING:
    1) disproportionate and persostent thoughts about seriousness of symptoms
    2) persistently high level of anxietty about health or symptoms
    3) excessive time and energy devoted to symptoms
72
Q

What is the main difference between illness anxiety disorder and SSD?

A

in IAD there are no physical symptoms (or only mild ones)

73
Q

what are the symptoms of IAD?

A
  • high anxiety about having/developing a serious ilness
  • excessive health related behavior
74
Q

how long do symptoms of IAD have to be present for a diagnosis?

A

6 months

75
Q

what are the 2 types of IAD patients?

A

1) care seeking
2) care avoidant

76
Q

what are the cognitive factors of SSD and IAD?

A
  • dysfunctional beliefs about illness
  • feel bodily sensations more intensly
77
Q

what are the psychological factors of SSD and IAD?

A
  • PTSD increases risk
  • stressful events
78
Q

what is the goal for cognitive therapy for SSD and IAD?

A
  • help people interpret their symptoms appropriately
  • avoid catastrophizing
79
Q

what is the goal of CBT for SSD and IAD?

A
  • challenging illness beliefs and misinterpretations
  • expose clients to triggers
80
Q

What are the symptoms of FNSD?

A
  • loss of neurological functioning in part of the body with no medical cause
  • can be sensory or motor
81
Q

what is the psychodynamic theory of FNSD?

A
  • transfer of psychic energy attached to repressed emotions or memories to physical symptoms
  • primary and secondary gain
82
Q

what is primary and secondary gain?

A

primary: reducing anxiety
secondary: people getting attention from others and being relieved of obligation

83
Q

what is the behavioral theory of FNSD?

A
  • learned behaviors that allowed people to escape responsibility or situations
  • La Belle Indifference
  • childhood trauma
84
Q

what is Le Belle Indifference?

A

soldiers became paralyzeand couldn’t return to battle

85
Q

what is the neurological theory of FNSD?

A

sensory or motor areas of brain affected by anxiety

86
Q

what is the goal of psychoanalytic therapy for FNSD?

A

helps express painful memories/emotions that are linked to symptoms

87
Q

what are the golas of CBT for FNSD?

A
  • systematic desensitization
  • relieve anxiety
  • relieving any benefits client is receiving from having symptoms
88
Q

what is factitious disorder?

A

faking an illness to gain medical attention

89
Q

what is malingering?

A

faking a symptom or disorder to gain something

90
Q

what is dissociation?

A

when parts on one’s self, memories, or consciousness become disconnected from one another

91
Q

what is the name for the different identities presented in DID?

A

alters

92
Q

what is a host alter?

A

the main personality that determines when the others get to present themselves

93
Q

when is the onset for DID?

A

childhood

94
Q

what is the course for DID?

A

chronic

95
Q

what is often comorbid with DID?

A
  • depression
  • PTSD
  • substance abuse
  • BPD
96
Q

what is the main theory of DID?

A

result of coping with intolerable illness

97
Q

what is the main form of treatment for DID?

A

3-Phase trauma focused therapy

98
Q

what is 3 phase trauma focused therapy

A

1) establish strong, trusting relationship and stabilize symptoms
2) processing, grieving, resolving trauma
3) integrate dissociated selves

99
Q

what happens in phase three of DID therapy?

A
  • give voice to each alter to see their purpose
  • allow each alter to grieve
100
Q

what are the symptoms of dissociative amnesia?

A
  • inability to recall autobiographical info
  • due to stress
101
Q

what is psychogenic amnesia?

A
  • amnesia from pschological causes
  • retrograde amnesia about personal info
102
Q

describe dissociative fugue states

A
  • a person travels to a new place and assumes new identity
  • no memory of previous identity
  • caused by stressor
103
Q

what is the theory of dissociative amnesia?

A
  • defense against intolerable memories
  • arousal impacts memory encoding
104
Q

what is the main form of treatment for dissociative amnesia and fugues? What is its goal?

A

psychotherapy aims to identify the stressors and learn coping skills

105
Q

describe depersonalization/derealization disorder

A

frequent episodes of feeling detatched from one’s own mental processes or body

106
Q

what is depersonalization?

A

losing sense of own reality

107
Q

what is derealization?

A

losing sense of reality of outside world

108
Q

what are causes for depersonalization/derealization disorder?

A
  • stress, sleep deprivation, durgs
  • childhood abuse
109
Q

what is the definition of a mood disorder?

A

severe alterations in mood for long periods of time with severe disruptions

110
Q

what is a state of depression?

A

extraordinary feelings of sadness

111
Q

what is a state of mania?

A

intense/unrealistic feelings of excitement/euphoria

112
Q

what are the 2 mood states?

A

1) depression
2) mania

113
Q

what are the cognitive symptoms in depression?

A
  • anhedonia
  • worthlessness, guilt, hopelessness
114
Q

what is anhedonia?

A
  • no interest in activities
  • stop engaging in thins they enjoy
115
Q

what are the physical symptoms of depression?

A
  • changes in appetite, sleep, activity
  • psychomotor retardation or agitation
116
Q

what are severe symptoms of depression?

A
  • delusions
  • hallucinations
  • suicide
117
Q

what are the 2 types of MDD?

A

1) single episode
2) recurrent episode

118
Q

how long must symptoms be present for MDD diagnosis?

A

2 weeks

119
Q

how many symptoms are needed for an MDD diagnosis?

A

5 of 9

120
Q

what constitutes recuurent episode MDD?

A

episodes must be separated by 2 months

121
Q

what cannot be diagnosed as MDD?

A

grief unless atypical behaviors are present

122
Q

what are the 8 specifiers for MDD?

A

1) anxious distress
2) mixed features
3) melancholic features
4) psychotic features
5) catatonic features
6) atypical features
7) seasonal pattern
8) peripartum onset

123
Q

what is the anxious distress specifier?

A

prominent anxiety symptoms

124
Q

what is the mixed features specifier?

A
  • 3 or more manic symptoms with depression
  • not enough to be a manic episode
125
Q

what is the melancholic features specifier?

A

prominent physiological symptoms

126
Q

what is the psychotic features specifier?

A

dellusions/hallucinations

127
Q

what is the catatonic features modifier?

A

strange physical behaviors
- lack of movement
- excited aggitation

128
Q

what is the atypical features specifier?

A
  • odd assortment of symptoms
  • does not mean rare
129
Q

what is the peripartum onset specifier?

A

onset during pregnancy or within 4 weeks of birth

130
Q

what are the criteria for persistent depressive disorder?

A
  • symptoms for most of the day for at least 2 years
  • 2 of 5 symptoms
131
Q

what are the comorbidities for persistent depressive disorder?

A
  • anxiety
  • subtance use
131
Q

how do symptoms of persistent depression differ from MDD?

A

they are longer lasting but less severe

132
Q

what are the required symptoms for premenstrual dysphoric disorder?

A
  • irritability
  • depressed mood
  • uncontrolled emotion
133
Q

what are the criteria fo premenstural dysphoric disorder?

A
  • symptoms arise within a week of cycle
  • distress or impairment
134
Q

what are the comorbidities for PMDD?

A
  • GAD
  • agoraphobia
  • Bipolar
  • PTSD
  • MDD
135
Q

what are the symptoms of mood dysregulation disorder?

A
  • severe and chronic irritability
  • persistently negative mood
  • severe temper outbursts
136
Q

what are the criteria for disruptive mood dysregulation disorder?

A
  • only ages 6-18
  • tantrums must be disproportionate to cause
  • behavior must be age inappropriate
137
Q

what is the course of depressive disorders?

A

long lasting and recurrent

138
Q

what are the comorbidities of disruptive mood dysregulation disorder?

A

-ODD
- coduct disorder
- ADHD
- depression

139
Q

how do MDD symptoms usually present in adolescents?

A

irritability

140
Q

what are the comorbidities of adolescent MDD?

A
  • ADHD
  • anxiety disorders
  • disruptive disorder
  • substance use
  • enureses (peeing yourself)
141
Q

describe a manic episode

A

abnormally, persistently elevated or irritable mood with goal directed activity or energy

142
Q

what is required for a manic episode?

A

symptoms last at least a week

143
Q

what are the cognitive/behavioral symptoms of mania?

A
  • impulsive behavior, rapid speech, racing thoughts
  • “flight of ideas” mind racing but can’t keep up verbally
  • grandiosity: inflated self-esteem
144
Q

what are the physical symptoms of mania?

A
  • increased energy
  • decreased sleep and appetite
145
Q

what are the severe symptoms of mania?

A

dellusions and hallucinations

146
Q

what is not needed for a manic episode diagnosis?

A

distress

147
Q

what are the symptoms of bipolar I?

A
  • elevated, expansive, or irritable mood
  • manic episode for more than a week
  • possible depressive episodes
  • possible dellusions/hallucinatinos
148
Q

what are the symptoms of bipolar II?

A
  • severe depression
  • hypomania
149
Q

what are the criteria for bipolar II?

A
  • NO dellusions/hallucinatinos
  • mania only needs to be present for 4 days
150
Q

what is not required for a bipolar I diagnosis?

A

depressive episodes

151
Q

what is the defining feature of cyclothymic disorder?

A

episodes not frequent, severe, or long enough for bipolar diagnosis

152
Q

what are the criteria for cyclothymic disorder?

A
  • episodes for at least 2 years
153
Q

what is the criteria for rapid cyling bipolar disorder?

A

4 or more episodes within a year

154
Q

what is the course of bipolar disorder?

A

recurrent

155
Q

explain the genetic theory of depression

A
  • there is a strong genetic component
  • polygenic
  • serotonin transport gene
156
Q

explain the neurotransmitter theory of depression

A

dysregulation of serotonin and norepinephrine

157
Q

explain the brain abnormalities theory of depression

A
  • less gray matter in prefrontal cortex
  • anterior singulate: stress/social behaviors and attention
  • smaller hippocampus
  • enlargement and overreactivity of amygdala
158
Q

explain the neuroendocrine theory of depression

A
  • elevated cortisol levels
  • chronic hyperactivity of HPA axis
159
Q

explain the behavioral theory of depression

A
  • stressors reduce positive reinforcers in a person’s life
  • learned helplessness
160
Q
A
161
Q

explain the cognitive theories of depression

A
  • negative cognitive triad: negative view of self, world, future
  • reformulated learned helplessness: focuses on attributions of stressors
  • ruminative response cycle: focus on process of thinking over content
162
Q

explain the interpersonal theory of depression

A
  • often from strained reationships
  • rejection sensitivity
163
Q

explain the sociocultural theories of depression

A
  • cohort effect
  • gender and race differences
164
Q

explain the genetic factor of bipolar disorder

A

5-10 times more likely

165
Q

explain the brain abnormality theory of bipolar disorder

A
  • altered structure and functioning of amygdala and prefrontal cortex
  • basal ganlgia: abnormal response to environmental rewards
166
Q

explain the neurotransmitter theory of bipolar disorder

A

dysregulation of the dopamine system

167
Q

what brain structure is linked to manic episodes

A

basal ganglia

168
Q

what are the psychological factors for bipolar disorder

A
  • greater sensitivity to rewards
  • increased stress
  • disruptions in routine
169
Q

what are the biological treatments of mood disorders?

A
  • medication
  • ECT
  • brain stimulation
  • light therapy
170
Q

what are the goals of behavioral therapy for mood disorders?

A
  • 6-12 weeks
  • teach skills to change negative circumstances
  • change how people interact
171
Q

whatare the goals of CBT for mood disorders?

A
  • designed to be brief
  • identify negative automatic thought
  • recognize basic beliefs/assumptions
  • learn new coping skills
172
Q

what are the four types of problems that intrpersonal therapy deals with?

A

1) grief/loss
2) role dispute
3) role transition
4) interpersonal skill deficits

173
Q

what is interpersonal and social rhythm therapy (ISRT) and what are its goals when treating mood disorders?

A
  • combo of interpersonal and behavioral therapies
  • help people maintain regular routines and realtionships
174
Q

what kind of therapy is least likely to hace a relapse for mood disorders?

A

psychotherapy